Tricuspid atresia medical therapy: Difference between revisions
(/* ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT){{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with conge...) |
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== Medical Therapy == | == Medical Therapy == | ||
*The mainstay of therapy for the cyanotic neonate with severe PS and small VSD is using prostaglandin E1 (PGE1) for keeping patency of ductus arteriosis. | *The mainstay of therapy for the cyanotic neonate with severe PS and small VSD is using prostaglandin E1 (PGE1) for keeping patency of ductus arteriosis. | ||
*The mainstay of therapy for heart failure symptoms is using diuretic for reloading and then starting ACEI. | *The mainstay of therapy for heart failure symptoms is using diuretic for reloading and then starting ACEI. | ||
Revision as of 16:04, 24 August 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Keri Shafer, M.D. [2] Priyamvada Singh, MBBS [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]
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Medical Therapy
- The mainstay of therapy for the cyanotic neonate with severe PS and small VSD is using prostaglandin E1 (PGE1) for keeping patency of ductus arteriosis.
- The mainstay of therapy for heart failure symptoms is using diuretic for reloading and then starting ACEI.
Surgery Surgery is the mainstay of therapy for tricuspid atresia. · In the first 8 weeks of life if there are severe cyanosis and pulmonary obstruction and normal positioning aorta and pulmonary artery, making a shunt between systemic subclavian artery to pulmonary artery is necessary which is called Blalock -Taussig(BT shunt). · If the pulmonary artery comes from the left ventricle and is overflowed, PA banding is useful for lowering the pulmonary blood flow. · In older children, bi-direction Glenn shunt which is the connection between superior vena cava to the pulmonary artery will be done for transferring the blood to the pulmonary system. Fontan procedure is a conduit between the inferior vena cava and the pulmonary artery and transfers the systemic venous blood to pulmonary circulation in the age of 2-3 years old. Endocarditis prophylaxis before every procedure is recommended.
| Class I |
| "1. Warfarin should be given for patients who have a documented atrial shunt, atrial thrombus, atrial arrhythmias, or a thromboembolic event. (Level of Evidence: C)" |
| Class IIa |
| "1. It is reasonable to treat systemic ventricular dysfunction with angiotensin-converting enzyme (ACE) inhibitors and diuretics. (Level of Evidence: C)" |